Healthy Home Offerings via the Mealtime Environment (HOME) Plus

通过用餐环境 (HOME) Plus 提供健康的家庭产品

• 批准号: 8286402
• 负责人: Jayne Allyn Fulkerson
• 金额: $ 64.22万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8286402
• 关键词: 12 year old; Address; Area; Attention; Behavior; Behavioral; Beverages; Body mass index; Calories; Child; Clinical Trials Design; Collaborations; Communities; Computers; Consumption; Eating; Environment; Family; Family member; Food; Frequencies; Gatekeeping; Goals; Health Food; Health Promotion; Home environment; Influentials; Intake; Intervention; Measurement; Methods; Minnesota; Neighborhoods; Obesity; Parents; Physical activity; Pilot Projects; Play; Prevention; Prevention approach; Prevention program; Prevention strategy; Process Measure; Psychological reinforcement; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Relative (related person); Reporting; Research; Research Training; Role; School-Age Population; Services; System; Telephone; Television; Testing; Translations; Treatment Efficacy; United States National Institutes of Health; Universities; Weight; Weight Gain; Work; after-school program; arm; base; cohort; community setting; design; efficacy testing; environmental intervention; follow-up; innovation; intervention effect; intervention program; metropolitan; nutrition; obesity in children; obesity prevention; post intervention; prevent; primary outcome; programs; public health relevance; randomized trial; role model; secondary outcome; sedentary; social cognitive theory; sound; tv watching

DESCRIPTION (provided by applicant): Childhood obesity is a serious public health problem with limited effective prevention strategies to date. Although previous nutrition and physical activity environmental approaches for obesity prevention show some promise, most studies have not shown reductions in excess weight gain. Moreover, few prevention studies significantly engage parents and focus on the home environment. To prevent childhood obesity it is essential to promote healthy behaviors in the home environment because parents are influential primary role models for healthy eating and sedentary behavior, and are gatekeepers for food and beverage availability and degree of inactivity within the home. Moreover, the home setting is where most of children's calories and energy dense foods are consumed and where children engage in much of their sedentary behavior, particularly screen time (e.g., television, computer, game system). The proposed study will test the efficacy of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus program, a year-long, family-based health promotion intervention to prevent excess weight gain among 8-12 year old children. The program is based on Social Cognitive Theory and a socio-ecological framework and promotes both regular and nutritionally-sound snacks and meals in which family members eat together (i.e., family meals) and encourages reductions in sedentary behavior, particularly screen time among children in the home setting. The efficacy of the intervention will be tested in a randomized controlled trial with 160 families randomized to two conditions (intervention or attention- only control). Two cohorts of families, recruited from before- and after-school programs and community centers, will be followed for 2.5 years. The primary hypothesis is that, by the end of the 12-month intervention, target children in the intervention families, relative to children in the control families, will have significantly lower body mass index (BMI; primary outcome) after adjustment for baseline BMI values. Secondary outcomes include frequency of weekly family meals and number of healthful foods and beverages available in the home and served at family meals and snacks (as reported by parent), target children's daily intakes of healthful foods and beverages, and target children's minutes of sedentary behavior per week, particularly screen time. Child and parent measurement will occur in their homes at baseline, post-intervention (12-months post- randomization), and follow-up (9-months post-intervention) by trained research staff. The proposed study builds upon successful methods from our HOME pilot study (2006-2008; NIH R21-DK0072997) and is innovative as it actively engages entire families in experiential activities and capitalizes on the home setting. The study will provide important information on environmental and behavioral strategies that families can use at home to prevent excess weight gain. The intervention program has high translation potential and is likely to be immediately useful to families of school-age children because it will be tested in real-world community settings and sustained across the state of Minnesota by the University of Minnesota's Extension Service. PUBLIC HEALTH RELEVANCE: The goal of the proposed project is to see if an innovative family-based intervention that focuses on making healthful food changes, especially at family meals, and reducing screen time (TV, game systems) within the home can prevent children from gaining more weight than they need to as they grow. The study will provide important information on strategies that families can use at home to prevent obesity. The intervention program is likely to be immediately useful to families of school-age children because it will be tested in real-world community settings.

描述（由申请人提供）：儿童肥胖是一个严重的公共卫生问题，迄今为止有效的有效预防策略有限。尽管以前的营养和体育锻炼环境预防环境方法表明了一些希望，但大多数研究尚未显示体重增加过多的减少。此外，很少有预防研究可以显着吸引父母并专注于家庭环境。为了防止儿童肥胖，在家庭环境中促进健康行为至关重要，因为父母是健康饮食和久坐行为的主要榜样，并且是家庭内部食品和饮料可用性和家庭不活动程度的守门人。此外，家庭环境是消耗儿童的卡路里和能量密集食品的地方，儿童从事大部分久坐的行为，尤其是屏幕时间（例如电视，计算机，游戏系统）。拟议的研究将通过进餐时间环境（Home）Plus计划，一年为期一年的基于家庭的健康促进干预措施来测试健康家居产品的功效，以防止8至12岁儿童体重增加。该计划基于社会认知理论和社会生态框架，并促进了家庭成员一起吃饭（即家庭餐）的常规和营养零食和餐食，并鼓励减少久坐的行为，尤其是在家庭环境中的儿童筛查时间。干预措施的功效将在一项随机对照试验中进行测试，其中160个家族随机分为两个条件（干预或注意力控制）。将遵循从课外和课后计划和社区中心招募的两个家庭，将遵循2。5年。主要的假设是，到12个月的干预措施结束时，相对于对照家族中的儿童，针对干预家庭中的儿童将在调整基线BMI值后的体重指数（BMI；主要结果）将显着降低。次要结果包括每周家庭用餐的频率以及在家中可用的健康食品和饮料的数量，并在家庭用餐和小吃中提供（如父母所报道），目标儿童每天对健康食品和饮料的每日摄入量，以及针对儿童每周的久坐行为，尤其是筛选时间。训练有素的研究人员将在基线，干预后（随机分组后12个月）和随访（9个月后）的儿童和父母测量。拟议的研究基于我们的家庭试点研究（2006-2008; NIH R21-DK0072997）的成功方法，并且具有创新性，因为它积极地吸引了整个家庭进行体验活动并在家庭环境中资本化。该研究将提供有关家庭可以在家中使用的环境和行为策略的重要信息，以防止体重增加。该干预计划具有很高的翻译潜力，并且可能会立即对学龄儿童家庭有用，因为它将在现实世界中的社区环境中进行测试，并由明尼苏达大学的扩展服务在明尼苏达州进行。 公共卫生相关性：拟议项目的目标是查看一项创新的基于家庭的干预措施，该干预措施着重于改变健康的食物，尤其是在家庭用餐中，并减少家庭内部的屏幕时间（电视，游戏系统）可以防止儿童获得比随着成长而增加的体重。该研究将提供有关家庭可以在家中预防肥胖症的策略的重要信息。干预计划可能会立即对学龄儿童家庭有用，因为它将在现实世界中进行测试。